腰硬联合与硬膜外麻醉对前列腺手术病人术中的不同影响

The Different Effect of Combined Spinal-epidural and Epidural Anesthesia on Patients During Prostatectomy

目的 :比较传统的硬膜外麻醉和腰麻 -硬膜外联合麻醉在前列腺摘除术中对病人的影响。方法 :将 80例行前列腺摘除手术的病人分为两组 :硬膜外组 (E组 )和腰麻 -硬膜外联合组 (CSE组 ) ,比较他们的血压 (BP)、心率(HR)、呼吸 (R)、血氧饱和度 (Pa O2 )及麻醉手术时间 (AOT)和病人的舒适度 (CD)。结果 :手术开始后 ,CSE组 BP和HR没有明显变化 (P>0 .0 5 ) ,而 E组的 BP先上升后下降 (P<0 .0 5 ) ,HR先加快后减慢 (P<0 .0 5 ) ;CSE组的 AOT较 E组短 (P<0 .0 5 ) ;CD评分 CSE组明显低于 E组 (P<0 .0 1)。结论 :腰麻 -硬膜外联合麻醉 (CSEA)具有腰麻和硬膜外麻醉的双重优点 ,对于下腹部手术 ,对血液动力学的影响较小 ,BP、HR均较稳定。 CSEA较单纯硬膜外麻醉提供了更好的交感、感觉和运动的阻滞 ,因而相应提供了极佳的肌松、极小的牵拉反应 ,便于手术的暴露和操作 ,缩短了手术时间 ,加以 CSEA起效快 ,取消了麻醉等待时间 ,使 AOT缩短 ,同时 ,病人的舒适程度明显提高。对年龄较大的实行下腹部手术的病人 ,采用

Objective To compare the different effect of combined spinal-epidural(CSE) and epidural(E) anesthesia on patients during prostatectomy.Methods 80 patients suffering benign prostate hyperplasia(BpH) were divided into two group:group CSE and group E. blood pressure(BP),heart rate(HR), rate of respiration(R), PaO 2,time of anesthesia and operation(AOT) and comfortable degree during operation(CD) were measured.Result After beginning of operation,HR and BP in group E increased and then decreased(P<0.05),in group CSE,there was no change;AOT of group CSE was shorter than that of group E(P<0.05);The CD of patients in group CSE was higher than those in group E (P<0.05).Conclusion CSEA could provide better muscle relaxation and nerve block,then more comfortable degree and short AOT and better safety were made.It is a good anesthetic method to old patients suffering prostatectomy.